Pharmacists in the Senior Center: Gateway to Better Communication

Senior centers—tucked into public buildings, snugly ensconced in church basements, or occupying sprawling, freestanding, modern buildings of their own—are ubiquitous across the United States. Originally designed as social centers for retired elders, over the years they evolved into service centers to help seniors address problems unique to their age group. Next, they became more like community centers, adding cultural events and classes.

Today, the 16,000 senior centers in the United States are apt to be more entrepreneurial than ever as they adjust to seniors’ changing needs, wants, and expectations. Millions of seniors take advantage of the companionship, aid, education, meals, and transportation offered.1 In many areas, pharmacists are finding senior centers an exceptional place to provide care.

A Successful Pharmacy Program

Paula Evans, PharmD, MS, CGP, and Donna Bartlett, PharmD, CGP, RPh, are academic faculty and clinical pharmacists who work, along with their students, in the Massachusetts College of Pharmacy and Health Sciences (MCPHS) Clinical Outreach Program. The 10-yearold program is a medical toll-free call center funded jointly by MCPHS and the Massachusetts Executive Office of Elder Affairs. Any Massachusetts resident can call and ask questions about medications, but the majority of callers are seniors. Questions often concern health care, drugs costs, and access to medication.

The program works closely with SHINE (Serving Health Insurance Needs of Elders), a statewide volunteer-based program that is part of the federal Senior Health Insurance Program (SHIP). Many states have SHIP chapters, usually staffed by older volunteers who help other seniors with health insurance matters such as filing claims and appeals, comparing Medicare supplemental policies, and organizing paperwork.

Drs. Evans and Bartlett also visit senior centers to provide drug information and education, provide “brown bag” reviews, discuss safety and adherence, speak at support groups, and target fall prevention. Their primary goal is keeping ambulatory seniors healthy. Drs. Evans and Bartlett report that pharmacists who work with seniors need a unique skill set. Both are certified geriatric pharmacists, and have a wealth of experience in geriatrics. One skill they stress is good communication, and the ability to adapt conversation to either face-to-face meetings or the telephone in a way that is respectful of the elderly patient. The Table lists some tips for communicating with elders.

Carol Geiler, director at the Ledyard Senior Center in Gales Ferry, Connecticut, says that her 200-member center generally serves around 40 seniors daily. Geiler notes, “For many seniors, transportation is a huge obstacle to proper health care. We offer transportation to and from medical appointments as well as prescription pickup.” She adds, “We have a weekly presentation that frequently involves a health care provider to discuss pertinent health care issues. Topics include falls, influenza, Alzheimer’s, nursing home care, insurance, living wills, safety in the home, driving concerns, nutrition, and healthy diets.”

Pharmacists are uniquely situated to deliver presentations on many of these topics, especially because they understand not just the health conditions of interest, but the medications and lifestyle interventions needed to treat them. And another reason to be familiar with your local senior center: when patients’ lack of transportation is contributing to declining health or nonadherence, linking them to area senior centers may help.

Not Just a Bunch of “Old People”

Ageism—stereotyping and discrimination against elderly people—is a pervasive problem, and health care providers are not immune. Younger people sometimes equate gray hair to diminished capacity. Many pharmacists who begin working in senior centers are surprised by the range of seniors’ physical and cognitive abilities. Some are young-elderly and robust and savvy; they look for programs with plenty of physical activity and are often computer-literate. Some are frail-elderly; they have serious health problems and may be in cognitive decline.

Some are very old, very robust, and more engaged and engaging than the pharmacist who is providing counseling! Getting to know seniors at senior centers—environments that are slower paced and less hectic than retail pharmacies—can help pharmacists deal more effectively with older patients at the retail dispensing window.

One change that is inevitable in almost all elders is visual decline. Drs. Evans and Bartlett work with a support group for the visually impaired; they help members become familiar with and adhere to their medications safely. They report that many elders who have not been identified as having low vision express a desire for health care professionals to acknowledge visual decline and supply tools to help them.

Getting Started

There are many reasons to work with senior centers. Pharmacists may want to develop better skills for dealing with seniors, who are, after all, the bulk of our clientele. They may want to conduct research and recruit seniors to participate in surveys or trials. One rewarding reason is to ensure that healthy, robust seniors stay that way, and to catch early any adverse drug reactions that may hinder their ability to enjoy life.

Interested pharmacists can contact their local senior centers directly, and then assess the center’s unique needs before volunteering. They can join a local SHIP chapter and benefit from the training they receive there. Partnering with the nearest school of pharmacy is also a good way to start a senior center program; many schools are interested in expanding clinical services, providing advice, and involving their students.

One cautionary note: Pharmacists should be careful to make their motivations clear and emphasize that they are not at the senior center to sell products or services.

Conclusion

Senior centers face many obstacles in this economy. Some report falling attendance rates, and many are concerned about decreasing public support from federal, state, and municipal funding sources. Those that are seeing steady or growing participation often have diversified programming and/or modernized facilities.1 Entrepreneurial pharmacists will find that senior centers are a good place to use clinical skills. PT

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.

References

1. National Council on Aging. ‘Senior Center’ research: is the phrase an oxymoron? www.ncoa.org/strengthening-community-organizations/senior-centers/nisc/senior-center-research-is.html. Accessed October 7, 2011.